Antenatal depression and adverse birth outcomes among pregnant women living with HIV in Dar es Salaam, Tanzania.

Journal: Journal of affective disorders

Volume: 339

Issue: 

Year of Publication: 2023

Affiliated Institutions:  Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA. Electronic address: mregan@g.harvard.edu. Management and Development for Health, Dar es Salaam, Tanzania. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA; Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA. Department of Obstetrics and Gynecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA. Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA.

Abstract summary 

Women who experience antenatal depression may be at increased risk of adverse birth outcomes. Few studies have examined this association among women living with HIV (WHIV).We conducted a prospective cohort study of 2298 pregnant WHIV on antiretroviral therapy (ART) in Dar es Salaam, Tanzania, who were participants in a randomized trial of vitamin D supplementation. Depressive symptoms were assessed at 12-27 weeks gestation using the Hopkins Symptoms Checklist (HSCL-25). Generalized estimating equations to account for twins were used to assess the relative risks of adverse birth outcomes.Approximately 67 % of the women in our study population reported symptoms consistent with depression. We observed a 4.0 % prevalence of stillbirth and a 25.1 % prevalence of preterm birth. We found that low social support, higher education, and more recent initiation of ART were associated with a greater risk of antenatal depression. There was no association of antenatal depression with risk of fetal loss, stillbirth, low birth weight, birth weight, preterm birth, gestational age at delivery, or small-for-gestational age.Depression was self-reported and only collected at one timepoint in pregnancy. Our findings may not be generalizable to all WHIV.Our findings illustrate the high risk of both depression and adverse birth outcomes among WHIV and underscore the need for interventions to improve their mental health and the health of their infants; however, the relationship between depression and birth outcomes remains unclear. Further research on this topic is merited, particularly examining the chronicity and timing of depression in pregnancy.

Authors & Co-authors:  Regan Mathilda M Muhihi Alfa A Saleh Arvin A Duggan Christopher P CP Ulenga Nzovu N Alwy Al-Beity Fadhlun M FM Aboud Said S Fawzi Wafaie W WW Manji Karim P KP Sudfeld Christopher R CR

Study Outcome 

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Statistics
Citations :  Accortt EE, Cheadle AC, Dunkel Schetter C. Prenatal depression and adverse birth outcomes: an updated systematic review. Matern Child Health J. 2015;19(6):1306–1337. doi:10.1007/s10995-014-1637-2.
Authors :  10
Identifiers
Doi : 10.1016/j.jad.2023.07.047
SSN : 1573-2517
Study Population
Female,Women
Mesh Terms
Infant
Other Terms
Depression;Low birth weight;Pregnancy;Preterm birth;Tanzania
Study Design
Cohort Study,Randomized Control Trial
Study Approach
Country of Study
Tanzania
Publication Country
Netherlands